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All Journal Oto Rhino Laryngologica Indonesiana Cermin Dunia Kedokteran
Widayat Alviandi
Department of Otorhinolaryngology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta
Health Professions Medicine & Pharmacology

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Management of otosclerosis with obliterated footplate and round window involvement Priyono, Harim; Sari, Anita Amalia; Zizlavsky, Semiramis; Alviandi, Widayat; Ranakusuma, Respati W.
Oto Rhino Laryngologica Indonesiana Vol. 52 No. 2 (2022): VOLUME 52, NO. 2 JULY - DECEMBER 2022
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v52i2.448

Abstract

ABSTRACTBackground: Otosclerosis with obliterated footplate describes a condition with an overgrowth of bone so that the oval window is almost indistinguishable from the surrounding area. The occurence of round window obliteration is uncommon. In such cases, surgery is more difficult to perform and the results are often unsatisfactory. Purpose: To find out the management option for obliterative otosclerosis. Case report: A 35-year-old-man with suspected bilateral otosclerosis. The patient underwent transcanal endoscopic stapes surgery of the left ear with large fenestra stapedotomy procedure. Clinical question: In adult patients with obliterative otosclerosis, does stapes surgery improve hearing function and reduce complication? Review method: Using PubMed, EBSCOhost, Scopus and Proquest to search for the evidence of randomised control trial (RCT), cohort and case-control studies. Critical appraisal was conducted using critical appraisal tools from Center for Evidence Based Medicine (CEBM), Oxford University and qFAITH for systematic review/meta-analysis. Result: The literature searching used eligibility criteria based on keywords from clinical question found one study regarding the evaluation of intra-operative factors in otoslecrosis surgery outcomes, which was relevant to our clinical question. Conclusion: Large fenestra stapedotomy or stapedectomy is the preferred surgical technique for the management of obliterative otosclerosis. The involvement of round window caused a sensorineural hearing loss (SNHL) component and has a worse prognosis of hearing outcome post operatively. A further study is required to assess the best management for obliterative otosclerosis. ABSTRAKLatar belakang: Otosklerosis dengan obliterasi footplate menggambarkan suatu kondisi pertumbuhan tulang yang berlebihan sehingga tingkap lonjong hampir tidak dapat dibedakan dengan daerah sekitarnya. Obliterasi sampai ke tingkap bundar jarang terjadi. Hal tersebut menyebabkan operasi lebih sulit dilakukan dan hasilnya seringkali tidak memuaskan. Tujuan: Untuk mengetahui pilihan tatalaksana otosklerosis obliteratif. Laporan kasus: Laki-laki 35 tahun dengan suspek otosklerosis bilateral. Pasien menjalani operasi stapes telinga kiri dengan pendekatan endoskopi transkanal menggunakan prosedur stapedotomi fenestra besar. Pertanyaan klinis: Pada pasien dewasa dengan otosklerosis obliteratif, apakah operasi stapes dapat memulihkan fungsi pendengaran dan mengurangi komplikasi? Telaah literatur: Pencarian bukti melalui database PubMed, EBSCOhost, Scopus dan Proquest. Untuk uji coba kontrol acak, kohort dan studi kasus-kontrol, penilaian kritis dilakukan dengan menggunakan penilaian kritis dari CEBM, Oxford University dan qFAITH untuk tinjauan sistematis/meta-analisis. Hasil: Penelusuran literatur berdasarkan kriteria dari pertanyaan klinis, didapati satu artikel mengenai evaluasi faktor-faktor intraoperatif yang relevan dengan pertanyaan klinis. Kesimpulan: Stapedotomi fenestra besar atau stapedektomi adalah teknik bedah yang lebih dipilih untuk tatalaksana otosklerosis obliteratif. Keterlibatan tingkap bundar menyebabkan komponen gangguan pendengaran sensorineural, dan memiliki prognosis hasil pendengaran pasca operasi yang kurang baik. Dibutuhkan studi lebih lanjut untuk menilai tentang penatalaksanaan terbaik untuk kasus otosklerosis obliteratif.
Financing hearing aids for patients with congenital deafness in Indonesia Zachreini, Indra; Bashiruddin, Jenny; Zizlavsky, Semiramis; Tamin, Susyana; Priyono, Harim; Mayangsari, Ika Dwi; Alviandi, Widayat; Supartono, Natasha; Soetjipto, Damayanti; Ranakusuma, Respati; Damayanti, Heditya; Alia, Dina; Hajar Haryuna, Tengku Siti; Harahap, Juliandi; Warto, Nirza; Fitria, Hidayatul
Oto Rhino Laryngologica Indonesiana Vol. 52 No. 1 (2022): VOLUME 52, NO. 1 JANUARY - JUNE 2022
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v52i1.550

Abstract

ABSTRACTBackground: The appropriate management of patients with congenital deafness is installing hearing aids, either external hearing aids or implanted in the ear (cochlear implant), aiming to reduce the medical and social burden, besides improving the quality of life of the sufferers. Objective: To ascertain the cost of hearing aids in patients with congenital deafness, in the form of external hearing aids or cochlear implants. Method: A descriptive study with cross-sectional design using questionnaires through interviews. The sample size was 535 mothers whose children had congenital deafness at 24 hospitals with facilities for establishing a diagnosis of congenital deafness in 17 provinces in Indonesia. Result: Most respondents were aged 30-39 years (55%), occupations were housewives (71.8%), and education level was high school (52.5%). The type of hearing aid used mostly was external (92.7%), with 45.9% paid by personal expense. The surgically planted hearing aids in 22 children was mostly cochlear implants (95.5%), which were financed by the Indonesian Healthcare and Social Security Agency (BPJS) plus personal costs (50%). Discussion: This study found that the most common type of hearing aid used by children with hearing impairments was external hearing aids (92.7%) through independent financing (45.9%). Only 7.3% of patients chose surgery in hearing habilitation, and 95.5% were cochlear implants. The small percentage of surgery were due to the high-priced of cochlear implants, and the government did not cover all financial expenses. Conclusion: Most external hearing aids were paid independently-out-of-pocket, while cochlear implant surgeries were funded by BPJS, plus extra costs independently. ABSTRAKLatar belakang: Penatalaksanaan terbaik untuk penderita tuli kongenital adalah pemasangan alat bantu dengar (ABD), baik berupa ABD eksternal maupun ABD yang ditanam dalam telinga (implan koklea), dengan tujuan untuk mengurangi beban medis dan sosial, serta meningkatkan kualitas hidup penderita. Tujuan: Untuk mengetahui seberapa besar biaya pemasangan ABD pada penderita tuli kongenital, baik berupa ABD eksternal maupun implan koklea. Metode: Penelitian deskriptif dengan rancangan cross sectional study menggunakan kuesioner melalui wawancara. Besar sampel 535 ibu yang anaknya menderita tuli kongenital pada 24 rumah sakit yang memiliki fasilitas penegakkan diagnosis tuli kongenital di 17 provinsi di Indonesia. Hasil: Sebagian besar responden berusia 30-39 tahun (55%), pekerjaan terbanyak adalah ibu rumah tangga (71.8%), dan tingkat pendidikan SMA (52.5%). Jenis ABD yang terbanyak adalah ABD eksternal (92,7%) dengan pembiayaan secara mandiri 45,9%. Pemasangan ABD dengan tindakan operasi dilakukan pada 22 anak, yang terbanyak adalah implan koklea (95,5%) yang dibiayai oleh Badan Penyelenggara Jaminan Sosial (BPJS) ditambah dengan biaya sendiri (50%). Diskusi: Penelitian ini mendapati bahwa ABD yang terbanyak digunakan oleh anak dengan gangguan pendengaran adalah ABD eksternal (92,7%) dengan biaya mandiri (45,9%). Habilitasi pendengaran dengan tindakan operasi hanya dilakukan pada 7,3% pasien, berupa implantasi koklea 95,5%. Kecilnya persentase habilitasi bedah dikarenakan tingginya harga implant koklea, dan bantuan dari BPJS tidak meliputi keseluruhan biaya. Kesimpulan: Sebagian besar pembiayaan alat bantu dengar eksternal secara mandiri, sedangkan operasi implan koklea menggunakan biaya BPJS ditambah biaya sendiri.
Perbaikan Pendengaran Pasien Otitis Media Efusi yang Autoinflasi: Laporan Kasus Berbasis Bukti Firmansyah, Ugiadam Farhan; Suryoadji, Kemal Akbar; Bashirudin, Jenny; Bramantyo, Brastho; Alviandi, Widayat
Cermin Dunia Kedokteran Vol 51 No 6 (2024): Cardiology
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v51i6.1024

Abstract

Background: Otitis media with effusion (OME) is the presence of middle ear fluid without acute ear infection signs or symptoms. OME is one of the causes of hearing loss. Chronic asymptomatic OME could be managed by careful waiting for 3 months because it is a self-limiting disease. During surveillance, autoinflation is a beneficial intervention with minimal side effects and high adherence. Objective: To evaluate the effectiveness of autoinflation to improve hearing in otitis media with effusion and hearing loss. Methods: Literature searching was conducted through PubMed, Cochrane, ScienceDirect, Scopus, and EBSCOHost with inclusion and exclusion criteria. The articles were selected and underwent critical appraisal using rapid critical appraisal of systematic review and level of evidence by the Oxford Centre for Evidence-based Medicine in 2011. Result: One systematic review and meta-analysis, or RCT, met the criteria. This article revealed a pooled estimate of RR 1.74; 95% CI [1.22-2.50] with a Z-score of 3.02 (p=0.0025). This result showed substantial significant (p=0.01) heterogeneity (I2=69%). Conclusion: OME patients with hearing loss who performed autoinflation >1 month had a 1.74 times greater chance of achieving hearing improvement than controls. Autoinflation with the Politzer method gives significant results in improving hearing loss. Large-scale RCT research is recommended to evaluate the effectiveness of autoinflation with the Politzer method or other available methods in OME patients with hearing loss.
Co-Authors Alia, Dina Alvin Reinaldo Bashirudin, Jenny Brastho Bramantyo Damayanti, Heditya Eka D. Safitri Firmansyah, Ugiadam Farhan Harahap, Juliandi Haryuna, Tengku Siti Hajar Hidayatul Fitria Jenny Bashiruddin Mayangsari, Ika Dwi Priyono, Harim Ranakusuma, Respati Respati W. Ranakusuma Restuti, Ratna Dwi Saleh, Rangga Rayendra Sari, Anita Amalia Soetjipto, Damayanti Sriyana, Ayu Astria Supartono, Natasha Suryoadji, Kemal Akbar Tamin, Susyana Warto, Nirza Yupitri Pitoyo Zachreini, Indra Zizlavsky, Semiramis